Panniculectomy: Procedure, complications, and recovery Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What to know about a panniculectomyMedically reviewed by Catherine Hannan, M.D. — By Sasha Santhakumar on July 21, 2022A panniculectomy is a surgical procedure that aims to remove excess fat and overhanging skin from the abdomen. An abdominal panniculus is a medical term that describes a layer of fatty tissue that is present in the lower abdominal area. Also known as body contouring surgery, a panniculectomy involves changing the shape and contour of the body by removing excess skin and fat that hangs from the abdomen. Many people may find fat below the bellybutton area, which they may refer to as a FUPA, to be the most difficult type of fat to lose. A person may require the procedure following significant weight loss, bariatric surgery, or pregnancy. A large panniculus may affect a person’s life in several ways, potentially resulting in infections, rashes, and difficulty walking. If the area does not respond to dietary changes and exercise, a person may be a candidate for a panniculectomy. In this article, we discuss the panniculectomy procedure, including what it involves, who may be a suitable candidate, and how it differs from a tummy tuck. Who may need one Share on PinterestVICTOR TORRES/StocksyTypically, the most common candidates for panniculectomies are people who have experienced dramatic weight loss. As a result of the sudden weight loss, the person may have excessive abdominal skin that may overhang the groin and pubic regions. Other reasons why a person may undergo a panniculectomy include:pregnancyprevious surgery, such as bariatric surgeryage Generally, the best candidates for a panniculectomy are individuals who are in relatively good health but have excess abdominal fat or skin that does not respond to diet and exercise. Additionally, the candidate must be at least 18 years of age. If an individual intends to continue losing weight, it is advisable to postpone surgery until they reach their desired weight. A panniculectomy offers an option for people who have lost a significant amount of weight but do not wish to undergo an abdominoplasty. How to prepare Before a panniculectomy procedure takes place, the person will likely undergo a medical evaluation by a doctor, which may also involve some lab tests. A person may need to adjust any current medications. Alternatively, a doctor may prescribe certain medications for the person to take before the procedure. They may also advise the person to avoid taking anti-inflammatory drugs, such as aspirin, or herbal supplements, as these may increase bleeding. As cigarette smoking can affect wound healing and the blood supply, it is necessary to stop smoking before the procedure takes place. Active smokers are not candidates for a panniculectomy. A doctor will also recommend that an individual maintain a stable weight for 6–18 months before the procedure. A person should arrange for someone to drive them home after the surgery is complete. They should also ensure that someone stays with them for at least the first night after surgery. Procedure A surgeon will perform the panniculectomy procedure, which they will begin by administering anesthetics. These medications put a person to sleep and prevent them from feeling pain during surgery. The medical team will choose the most suitable anesthetic for the person. The procedure itself will involve an incision in the area between the bellybutton and the pubic hairline. The shape and length of the cut will depend on the amount of extra skin that the surgeon aims to remove. The surgeon will cut deeper until they get down to the muscle. Following this, they will pull down and remove the excess skin and fat before using sutures to close the wound. Before closure, the surgeon may place suction drains to prevent excess fluid from accumulating. They may also reposition the bellybutton stem and pull it through the new opening of the abdomen. Panniculectomy vs tummy tuck A panniculectomy is different from an abdominoplasty, which is also known as a tummy tuck. Although the procedures are similar, they are distinct. A tummy tuck is a type of cosmetic surgery that aims to remove excess skin and fat from the abdominal region and strengthen the abdominal wall. It also involves stitching the two sides of the rectus abdominis muscle together. A panniculectomy is a functional surgery that aims to minimize the complications of the excess skin and fat by removing them. A 2022 retrospective study found that a panniculectomy was more likely to lead to complications than a tummy tuck. Complications that a person may experience include:infectionswound separationsepsisbleedingreadmission to hospitalre-operation Recovery After surgery, a person may need to stay in the hospital for a few days. After the anesthesia wears off, medical staff may ask the individual to get up and walk a few steps. It is common to experience some pain and swelling, so a doctor will likely prescribe pain relievers. The person may also benefit from resting with the legs and hips bent to reduce pressure on the abdomen. A person may also receive a compression garment to wear. This reduces swelling and supports the abdomen while it heals. The surgeon may also place small temporary drains under the skin to drain any excess fluid that accumulates. A person is likely to start noticing the results of the procedure within 1–2 weeks. They may not be able to return to work for several weeks and should avoid strenuous activities for 6–8 weeks. It can take a few months for the swelling to go down and the wounds to heal. In some cases, it may take a couple of years for scars to fade and for a person to see the final results of the surgery. Complications A panniculectomy is typically a successful procedure, but it does have a high complication rate. A 2021 retrospective review found that the procedure has a 22.3% postoperative complication rate. According to the study, people with a higher body mass index (BMI) and those who smoke have an increased risk of postoperative complications. Potential panniculectomy complications include:poor wound healingfluid collecting under the skinskin infectionsabscessesblood collecting under the abdominal flapwound separationinjury to the blood supply of the abdomenblood clots Cost The cost of a panniculectomy can vary depending on a variety of factors, including:the location of the surgeon or clinicthe level of experience of the surgeonhospital fees and costsprescriptions for medicationmedical tests and X-raysthe amount of excess skin and fat that the surgeon will remove Anecdotal sources suggest that the cost of the surgery is in the range of $7,000–18,000. A person’s insurance provider may cover the procedure. However, this will depend on several factors, such as whether the procedure is cosmetic or medically necessary and whether symptoms such as skin irritation respond to medication. A person should check with their insurance provider regarding these requirements. In some cases, they might need to provide a letter from their primary care physician confirming that the procedure is medically necessary. Summary A panniculectomy is a surgical procedure that aims to remove overhanging excess skin and fat from the lower abdomen, which is known as a panniculus. This may occur after significant weight loss, such as after bariatric surgery. The procedure involves cutting the excess skin and suturing the remaining skin together. This procedure differs from a tummy tuck as it is a functional surgery and not cosmetic. Additionally, unlike a tummy tuck, the surgeon will not strengthen and tighten the abdominal wall muscles during a panniculectomy. Recovery may take several weeks or months, and it may take up to 2 years for a person to see the final results. As it is a functional surgery, a person’s insurance may cover some costs of the procedure. However, a person will need to speak with their insurance provider to determine whether their insurance plan covers a panniculectomy. Last medically reviewed on July 21, 2022Surgery 11 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Body contouring after major weight loss. (n.d.). https://www.brighamandwomens.org/surgery/plastic-surgery/procedures/body-contouring-after-major-weight-lossDreifuss, S., et al. (2016). Insurance coverage for massive weight loss panniculectomy: A national survey and implications for policy [Abstract]. https://pubmed.ncbi.nlm.nih.gov/26707933/Janis, J. E., et al. (2020). Panniculectomy: Practical pearls and pitfalls. https://journals.lww.com/prsgo/fulltext/2020/08000/panniculectomy__practical_pearls_and_pitfalls.43.aspxKalmer, C. L., et al. (2022). Functional panniculectomy vs cosmetic abdominoplasty: Multicenter analysis of risk factors and complications [Abstract]. https://pubmed.ncbi.nlm.nih.gov/35705442/Kuruoglu, D., et al. (2021). Abdominal panniculectomy: An analysis of outcomes in 238 consecutive patients over 10 years. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613336/Larowe, E. (2016). Panniculectomy post-operative instructions. https://www.med.umich.edu/1libr/Surgery/PlasticSurgery/Panniculectomy-postop.pdfPanniculectomy is performed to remove abdominal fat and skin. (n.d.). https://www.uhhospitals.org/services/plastic-surgery-services/Conditions-and-Treatments/body-contouring-and-reconstruction/procedures/abdominal-fat-removalPanniculectomy. (n.d.). https://www.plasticsurgery.org/reconstructive-procedures/panniculectomyPanniculectomy/abdominoplasty. (2020). https://health.maryland.gov/mmcp/Documents/Panniculectomy%20and%20Abdominoplasty%20Clinical%20Criteria.pdfRegan, J.-P., et al. (2021). Abdominoplasty. https://www.ncbi.nlm.nih.gov/books/NBK431058/Sachs, D., et al. (2022). Panniculectomy.https://www.ncbi.nlm.nih.gov/books/NBK499822/FEEDBACK:Medically reviewed by Catherine Hannan, M.D. — By Sasha Santhakumar on July 21, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageHow to get rid of fat in the upper pubic area (FUPA)Medically reviewed by Danielle Hildreth, CPT Many people dream of having a flat stomach and rock-hard abs. However, fat in the upper pubic area (FUPA) can be difficult to lose. Learn how to get…READ MORETummy tuck recovery: Timeline and tipsMedically reviewed by Catherine Hannan, M.D. A person's recovery time after a tummy tuck may depend on several factors, including their age and the type of tummy tuck they have. Learn more here.READ MORECosmetic surgery: What you should knowMedically reviewed by Catherine Hannan, M.D. Cosmetic surgery is a type of plastic surgery that aims to improve appearance. Find out about the types available and get some tips on choosing wisely.READ MOREWhat is an esophagogastroduodenoscopy?Medically reviewed by Cynthia Taylor Chavoustie, MPAS, PA-C An EGD is a procedure that doctors use to look inside the upper gastrointestinal tract. Learn more about its uses and what to expect here.READ MOREWhat is a myomectomy? What is a myomectomy procedure? Read on to learn more about this surgery, including what it involves, who is a candidate, and the different types.READ MORE